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Fever, persistent cough and fatigue lead list of ‘classic’ symptoms of COVID-19, study confirms

Other top symptoms were loss of smell and difficulty breathing. And, of course, people with COVID-19 can be entirely symptom-free.

A woman gets her temperature checked
REUTERS/Athit Perawongmetha
The analysis revealed that the most common symptom was fever, which was experienced by 78 percent of the patients across all the studies.
A fever and a persistent cough are the most common symptoms reported by people with COVID-19, according to a major new review of dozens of studies from around the world.

Other major symptoms include fatigue, loss of smell and difficulty breathing.

These findings back up the list of symptoms that the World Health Organization (WHO) issued when the pandemic started, as well as those currently listed by the U.S. Centers for Disease Control and Prevention (CDC).

Yet, although this is the largest review done to date on COVID-19 symptoms, its findings come with a major caveat. As the review’s authors point out, many people who have the virus do not display symptoms.

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So everybody should take precautions against spreading COVID-19 to others — including wearing a mask — whether they have symptoms or not.

International data

Published this week in the journal PLOS One, the review was conducted by a team of primarily British researchers from the University of Leeds. They combined and analyzed data from 148 separate studies from nine countries (the United States, the United Kingdom, China, Singapore, Italy, Australia, Japan, Korea and the Netherlands). The studies involved 24,410 adults with laboratory-confirmed cases of COVID-19. The average age of the patients was 49.

The analysis revealed that the most common symptom was fever, which was experienced by 78 percent of the patients across all the studies. The prevalence of this symptom ranged from 83 percent in Singapore to 32 percent in Korea.

A persistent cough was the second-most common symptom, reported by 57 percent of the patients. Its prevalence ranged from 76 percent in the Netherlands to 18 percent in Korea.

Other top symptoms were fatigue (31 percent), loss of smell (25 percent) and difficulty breathing (23 percent).

The severity of the symptoms varied. Of the patients who required hospitalization, 19 percent were admitted to an intensive care unit, 17 percent needed non-invasive help with their breathing and 9 percent required invasive mechanical ventilation. In the 73 studies that reported treatment outcomes, approximately 10 percent of the patients died (938 out of 10,402).

“This analysis confirms that a cough and fever were the most common symptoms in people who tested positive with COVID-19,” says Ryckie Wade, the study’s senior author and a surgeon and clinical researcher at Leeds University, in a released statement. “This is important because it ensures that people who are symptomatic can be quarantined, so they are not infecting others.”

“The study gives confidence to the fact that we have been right in identifying the main symptoms, and it can help determine who should get tested,” he adds.

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Know all the symptoms

Still, the absence of any of these major symptoms doesn’t necessarily mean a person is virus-free. As Wade and his colleagues point out in their paper, about one in five of the COVID-19 patients in the studies reviewed never had a fever, and fewer than three in five developed a cough.

And, of course, people with COVID-19 can be entirely symptom-free.

To ensure you don’t spread the disease to others, stay home and if you must go out, wear a mask, practice physical distancing and keep your hands clean. Also, be alert to all the possible symptoms of the virus. Here’s the CDC’s list:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

If you develop these signs of COVID-19, stay home, isolate yourself from others, and reach out to your health care provider. The CDC has an online “self-checker” that can help you make decisions about seeking appropriate medical care.

FMI: You can read the full review online in PLOS One.